Thrombogenic potential of non-ionic contrast media--fact or fiction?

Abstract

The role of contrast media in determining the occurrence of thromboembolic complications is not easy to define. Contrast media have a series of effects on blood constituents and on the hemostatic system. As for in vitro studies, it is generally agreed that ionic contrast media are stronger anticoagulants than nonionic, this being due to the fact that nonionic media are more inert on biological systems. This has been confirmed also in a recent paper comparing a nonionic monomer (iopamidol) with an ionic monomer (diatrizoate) and an ionic dimer (ioxaglate). Clinical data failed to demonstrate a greater thrombogenicity of one class of contrast media with respect to the other. The occurrence of thromboembolic complications in coronary angiography and PTCA is mostly related to operator experience and type of angiographic procedure.